Duke Heart Failure

1. How much money is Duke University health System losing?

Amount received by the medical school in 2001 = $ 203 million

Amount awarded by National Heart Lung Blood Institute for 3000 patient trial = $ 37

million

Value of the Health System caring for 33,000 employees and dependents = $ 1.2 billion

Total = $ 1.44 billion

Duke’s Loss per year Medicare = $ 300,000

Seed money by Duke to the salary program = $ 125,000

Salary and Benefits of 3 NPs and 10 cardiologists = $ 80, 000 x 13 = $ 1040,000

2. What are the financial results of the CHF disease management program?

Hint: Examine revenue and cost impacts for the Hospital (inpatient and outpatient) and Physicians perspective.

According to the American Heart Association, the annual direct cost was estimated to be $ 22.2 billion to treat the CHF patients, in addition to $ 2.1 billion in the loss of productivity. The costs of the hospital were about 60 percent of the direct costs of CHF. Hospital readmission rates were about 2 percent with in 2 days, 20 percent with in 1 month, and 50 percent for 6 month time. The only one largest expense for Medicare was CHF and it was also the basic cause of admission in emergency room among the Medicare population. Non-compliance of diet and medication resulting in readmission was about 33 percent to 64 percent whereas 35 percent of readmissions were related to inadequate discharge planning or follow- up.

3. What are the pros and cons of the CHF disease management program like the one at Duke from the perspective of payers, providers, employers, patients, and a private carve-out?

Disease management (DM) was basically a proactive form of medical care so as to manage chronic conditions and avoid costly hospitalizations and problems before they occur. It focuses on the communication with patients and physicians, coordination of care...